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Fundamentals · chapter 17 · Patient and Family Education

Evaluation of Teaching and Learning

The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.

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Key points

  1. Evaluation of goals

    The evaluation step of the nursing process allows nurses to determine whether goals were met using the interventions created. Similar to the nursing process, the education of patients and families must also be evaluated for its efficacy.

  2. Analyzing results

    It is also important for the nurse to analyze results and interpret how they influence the next steps for the patient.

  3. Unmet goals

    If goals have been achieved, the education on a topic or topics may be concluded. If goals are unmet, however, the process continues with reassessment.

  4. Teaching versus learning

    Teaching may take place separate from learning; an educator can present information and concepts, yet learning may not be effective and established goals may not be achieved.

  5. Objective learning measures

    Nonverbal responses like nodding or shaking the head may contribute to the evaluation of learning, but specific and objective measures, such as direct observation of actions, demonstration of an acquired skill, verbalization of comprehension, and use of a checklist, offer more reliable corroboration of learning.

  6. Checklists and observation

    Direct observation is frequently combined with checklists as a way to minimize subjectivity and maximize objectivity in observational evaluation (Nayyeri et al., 2021). Checklists provide clear descriptions of criteria for the actions under evaluation.

  7. Informal observation

    This often does not include a formal tool like a checklist, but it is during such activities that the nurse can monitor whether a patient who has been taught careful mastication and swallowing techniques is using those techniques for safety and aspiration prevention.

  8. Return demonstration process

    This evaluation method involves the nurse educating the patient and/or family with a combination of verbal explanation and showing the process of a particular skill.

  9. Practice before evaluation

    After the primary demonstration, the learner is offered an opportunity to ask questions and practice before evaluation of return demonstration.

  10. Skill mastery factors

    Mastery varies depending on the complexity of the skill, abilities of the learners, and expectations as to how many teaching and learning sessions required.

  11. Verbal understanding

    Asking open-ended questions that require more than one-word answers can illustrate acquisition of learning. Giving patients and family members an opportunity to describe what they comprehend at various intervals provides the nurse with insight about how much they know and understand.

  12. Teach-back clarification

    By asking the patient to recall information and explain it in their own words, the nurse can get a better understanding of what information was retained and what information needs to be retaught or clarified.

  13. Checklist uses

    Checklists can serve as an independent evaluation or provide documentation of evaluation, such as direct observation of actions, return demonstration of skills, and verbalization of understanding.

  14. Care plan modification

    Teaching efficacy is reflected by whether the patient learned what was taught and if the learner’s goals were achieved. If evaluation of the data indicates one or more goals set prior to the educational intervention were not met, the care plan may be modified to meet the goals for the patient.

Terms to know

direct observation of actions
Observing the learner in normal setting for actions and behaviors illustrating learning acquisition is referred to as direct observation of actions.
return demonstration
A patient or family member’s ability to demonstrate a psychomotor skill (or multiple skills) after having it is presented by the nurse is referred to as a return demonstration, which has the patient showcase the ability to complete the task by performing it back to the educator.
skill acquisition
When a patient or family member can demonstrate a newly acquired skill with precision, this is known as skill acquisition.
teach-back method
The teach-back method is a commonly used technique in health care whereby the patient or family member is asked to repeat, in their own words, the information they received through education.

Practice questions

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  1. A nurse has just finished discharge teaching with a patient. The patient smiles and nods after each instruction. What is the nurse’s best next action to evaluate whether learning occurred?

    1. Document that the patient understood because the patient used positive nonverbal responses.
    2. End the teaching session because the patient appeared polite and attentive.
    3. Repeat the same teaching session without asking the patient any questions.
    4. Ask the patient to explain the instructions in their own words.

    Answer: Ask the patient to explain the instructions in their own words.

    Smiles and nods may be politeness rather than proof of understanding. Asking the patient to explain the information in their own words gives the nurse a more objective way to evaluate what was retained and what may need clarification.

  2. A nurse wants to use direct observation of actions to evaluate patient learning. Which nursing actions fit this method? Select all that apply.

    1. Observing a patient ambulating with a family member to assess use of a gait belt or assistive device.
    2. Asking the patient to nod if they understood the teaching.
    3. Listening as a parent explains to a child why there is no breakfast tray on the morning of surgery.
    4. Having the patient perform a newly taught skill back to the nurse immediately after the nurse’s demonstration.
    5. Watching a patient eat and drink to see whether taught swallowing techniques are being used.

    Answer: Observing a patient ambulating with a family member to assess use of a gait belt or assistive device., Listening as a parent explains to a child why there is no breakfast tray on the morning of surgery., Watching a patient eat and drink to see whether taught swallowing techniques are being used.

    Direct observation evaluates learning by observing actions or hearing explanations in a normal setting, often without the learner realizing they are being evaluated. Nodding is not a reliable objective measure, and performing a skill back to the nurse after a demonstration is return demonstration rather than direct observation.

  3. A nurse has taught a family member how to change a patient’s wound dressing. Which evaluation method best determines whether the family member can perform this psychomotor skill?

    1. Give the family member written instructions and place them in the discharge folder.
    2. Ask the family member to smile or nod after each step is reviewed.
    3. Observe the family member changing the dressing and describing the wound and drainage.
    4. Ask the family member whether they feel ready to do the dressing change at home.

    Answer: Observe the family member changing the dressing and describing the wound and drainage.

    For a psychomotor skill, the nurse should evaluate whether the learner can perform the task. Observing the dressing change and listening to the description of the wound and drainage directly evaluates the skill and related understanding.

  4. A nurse is evaluating whether a patient has achieved skill acquisition after being taught a new task. Which findings support that the patient is developing proficiency or full understanding? Select all that apply.

    1. The patient can only nod while watching the nurse perform the skill again.
    2. The patient performs the skill correctly with precision.
    3. The patient can perform the skill properly, promptly, and converse at the same time.
    4. The patient refuses to practice but states that the teaching was clear.
    5. The patient performs the skill more rapidly while maintaining accuracy.

    Answer: The patient performs the skill correctly with precision., The patient can perform the skill properly, promptly, and converse at the same time., The patient performs the skill more rapidly while maintaining accuracy.

    Skill acquisition includes correct performance with precision, and proficiency includes increased speed while maintaining accuracy. Being able to perform the task promptly while conversing supports full understanding; nodding or refusing to practice does not demonstrate skill performance.

  5. After teaching a patient how to complete a required self-care skill, the nurse evaluates the patient and finds that the learning goal was not met. What should the nurse do next?

    1. Continue the process with reassessment and revise the goals, teaching methods, or both as indicated.
    2. Repeat the exact same teaching method until the patient meets the goal.
    3. Document that the patient is unable to learn the skill and stop further education.
    4. Conclude the education because the teaching session was already completed.

    Answer: Continue the process with reassessment and revise the goals, teaching methods, or both as indicated.

    When goals are unmet, the education process continues rather than ending. Reassessment helps identify updated learning needs and whether goals, teaching methods, or both need revision.

  6. A nurse is planning to use a checklist during evaluation of patient teaching. Which uses of a checklist are appropriate? Select all that apply.

    1. Serving as an independent evaluation method.
    2. Providing documentation of direct observation, return demonstration, or verbalization of understanding.
    3. Allowing notations for listed skills and levels of performance.
    4. Replacing the need to analyze whether patient goals were achieved.
    5. Helping objectify the evaluation process for complex skills or processes.

    Answer: Serving as an independent evaluation method., Providing documentation of direct observation, return demonstration, or verbalization of understanding., Allowing notations for listed skills and levels of performance., Helping objectify the evaluation process for complex skills or processes.

    Checklists may be used alone or to document other evaluation methods, and they help make evaluation more objective. They can include skills, performance levels, signatures, and comments, but they do not replace analysis of whether teaching was effective and goals were met.

Where every quote comes from

Section 17.4 Evaluation of Teaching and Learning of Fundamentals of Nursing by Christy Bowen, Lindsay Draper, Heather Moore, OpenStax, 2024. Read the whole section free at openstax.org.

The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.